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Several times a week, Mohamed ‘Momo’ Ag Malha journeys at least 7 miles (11km) around the sprawling Mbera refugee camp in south-eastern Mauritania that has been his residence since 2012. The routine keeps the 84-year-old camp elder vigorous, and allows him to assess the wellbeing of other occupants.

His initial stay in Mauritania occurred in 1991, when he left Mali as Tuareg separatists fought with the army in his native Timbuktu province.

After four years as a refugee, he went back and worked for a year as a social worker before transitioning to a teacher. Then in 2012, the Tuareg conflict once again pushed him across the border.

The former math and science teacher says he feels particularly sorry for the younger inhabitants of Mbera, which is located approximately 30 miles from the Malian border.

“Some of the kids who were born here in Mbera have not laid eyes on Mali,” he says. “They do not know their country [and] that is painful because a refugee always has two hearts: one here, where he lives, and another over there, in his homeland, which he dreams of returning to one day.”

Originally planned as a few thousand shelters, Mbera now accommodates around 120,000 refugees, according to the UN refugee agency. In addition, it is estimated that at least 154,000 refugees dwell in nearby villages across the Hodh Ech Chargui region. More than half are under 18.

Government authorities say the area is the number three human encampment in Mauritania after Nouakchott and Nouadhibou, the administrative and commercial hubs.

Each month, thousands more refugees come across the border, escaping a jihadist insurgency that co-opted the Tuareg rebellion and has since left extensive areas of the country ungovernable. Aid workers – particularly at the UN World Food Programme (WFP) and Unicef office in the town of Bassikounou, which services the camp and adjacent settlements – cannot stop feeling anxious. They have faced dwindling resources as foreign donors – most notably the now discontinued USAID – have drastically cut funding this year.

“We’ve gone from [being able to] support almost 90,000 people with both nutritional aid or money every month to about 53,000 … and had to discontinue vital nutrition programmes for undernourished children and mothers due to financial constraints,” says Aliou Diongue, country director for WFP.

The camp has many of the characteristics of a long-term settlement, including its own financial institution, eight schools, a market with more than 500 stores, and volleyball and football initiatives. Members of a parent-teacher association use amplifiers to get more children registered in school. New entrants are registered by aid workers and state agents using biometric systems.

Nearby, gendarmerie patrols protect the camp from the risk of fighters just a few miles from the border.

Some residents have assumed new responsibilities with zeal: volunteers in the SOS Desert organisation cultivate food for sale and run an blaze control team putting out bushfires; members of a women’s resource network look after those wounded by jihadist attacks and pregnant women while also promoting awareness about schooling girls.

But the camp’s requirements are obvious.

“We have the desire, we have the women, but not enough financial support or materials,” a leading member of the network says. “Sometimes we recycle what little we have, but it is not enough for the demands of the camp.”

In the schools, the children are provided one meal daily by WFP. At one school with 100 children per class, six or seven of them sit by a big tray to eat the same meal every school day – rice that is largely basic, save for a few pulses.

“We’re still supplying school meals, staple provisions, and monetary aid in the Mbera camp, but it’s not enough,” says Diongue. “We’re concentrating on the most at-risk while working continuously to obtain new funding through the broadening of our donor base.”

The meals are supported by recent donations including several thousand tonnes of rice supplied by the South Korean government – the only goods in a bulk of the warehouses. A few donors are also helping initiate self-sufficiency programmes to help refugees farm and keep animals so they can make money and enhance their quality of life.

Though Malha oversees everything responsibly, helping the aid workers’ cater to the most vulnerable households, his heart longs to return to Mali.

“When you leave your country, you forfeit everything – your work, your home, your family sometimes,” he says. “Here, you are entirely reliant on humanitarian aid. Sometimes that aid is enough, sometimes it is not. And when it is not, you suffer.

“We are grateful to the Mauritanian authorities and the humanitarian organisations for what they have done for us but it is not the same as being in your own country, working with your own hands and living with pride.”