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Many times a week, Mohamed ‘Momo’ Ag Malha walks at least 7 miles (11km) around the enormous Mbera refugee camp in southeastern Mauritania that has been his dwelling since 2012. The routine keeps the 84-year-old camp elder healthy in mind and body, and enables him to check on the condition of other residents.

His initial stay in Mauritania came in 1991, when he fled Mali as Tuareg separatists clashed with the army in his home Timbuktu province.

After four years as a refugee, he returned home 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 deeply sympathetic for the younger inhabitants of Mbera, which is situated approximately 30 miles from the Malian border.

“Some of the children who were born here in Mbera have not once visited Mali,” he says. “They do not know their nation [and] that is difficult because a refugee always has dual loyalties: one here, where he lives, and another over there, in his homeland, which he hopes to go back to one day.”

First established as a few thousand dwellings, Mbera now houses around 120,000 refugees, according to the UN refugee agency. In furthermore, it is approximated that at least 154,000 refugees dwell in nearby villages across the Hodh Ech Chargui region. More than half are under 18.

Government representatives say the area is the third-biggest human settlement in Mauritania after Nouakchott and Nouadhibou, the governmental and business capitals.

Each month, thousands more refugees pour in across the border, escaping a extremist rebellion that co-opted the Tuareg rebellion and has since left large parts of the country lawless. Aid workers – particularly at the UN World Food Programme (WFP) and Unicef office in the town of Bassikounou, which supports the camp and nearby settlements – cannot stop worrying. They have faced declining resources as foreign donors – most notably the now discontinued USAID – have sharply reduced funding this year.

“We’ve gone from [being able to] help almost 90,000 people with both food or cash every month to about 53,000 … and had to halt essential nutrition programmes for undernourished children and mothers due to financial constraints,” says Aliou Diongue, country director for WFP.

The camp has many of the trappings of a established settlement, including its own bank, eight schools, a market with more than 500 stores, and volleyball and football programmes. Members of a parent-teacher association use megaphones to get more children enrolled in school. New comers are documented by aid workers and state agents using fingerprint technology.

Nearby, security patrols guard the camp from the risk of militants just a few miles from the border.

Some residents have assumed new duties with gusto: volunteers in the SOS Desert organisation grow crops for sale and manage an blaze control team putting out bushfires; members of a women’s resource network care for those maimed by jihadist attacks and pregnant women while also promoting awareness about schooling girls.

But the camp’s demands are evident.

“We have the determination, we have the women, but not enough resources or equipment,” a leading member of the network says. “Sometimes we repurpose 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 cluster by a big tray to eat the same meal every school day – rice that is almost plain, save for a few pulses.

“We’re still supplying school meals, staple provisions, and financial support in the Mbera camp, but it’s not enough,” says Diongue. “We’re prioritizing the most at-risk while working continuously to acquire new funding through the expansion of our donor base.”

The meals are funded by recent gifts including several thousand tonnes of rice donated by the South Korean government – the only items in a bulk of the warehouses. A few donors are also helping start self-sufficiency programmes to help refugees cultivate and raise animals so they can make money and improve their quality of life.

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

“When you leave your country, you forfeit everything – your work, your home, your family sometimes,” he says. “Here, you rely solely on humanitarian aid. Sometimes that aid is sufficient, sometimes it is not. And when it is not, you struggle.

“We thank 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 dignity.”