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Many days a week, Mohamed ‘Momo’ Ag Malha journeys 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 coordinator healthy in mind and body, and permits him to monitor the wellbeing of other inhabitants.

His initial stay in Mauritania happened in 1991, when he left Mali as Tuareg rebels battled with the army in his native Timbuktu province.

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

The former mathematics and physics teacher says he feels particularly sorry for the young people of Mbera, which is positioned approximately 30 miles from the Malian border.

“Some of the young ones who were born here in Mbera have not once visited Mali,” he says. “They do not know their country [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 dreams of returning to one day.”

First established as a few thousand huts, Mbera now accommodates around 120,000 refugees, according to UNHCR. In also, it is estimated that at least 154,000 refugees reside in nearby villages across the Hodh Ech Chargui region. More than half are under 18.

Government authorities say the area is the third largest human settlement in Mauritania after Nouakchott and Nouadhibou, the administrative and commercial capitals.

Each month, thousands more refugees come across the border, fleeing a extremist rebellion that co-opted the Tuareg rebellion and has since left swathes of the country ungovernable. Aid workers – particularly at the UN World Food Programme (WFP) and Unicef office in the town of Bassikounou, which supports the camp and neighbouring settlements – cannot stop being concerned. They have faced shrinking resources as foreign donors – most notably the now ceased USAID – have severely slashed 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 halt vital nutrition programmes for undernourished children and mothers due to budget reductions,” says Aliou Diongue, country director for WFP.

The camp has many of the characteristics of a established 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 enrolled in school. New arrivals are documented by aid workers and state agents using biometric systems.

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

Some residents have adopted new responsibilities with zeal: volunteers in the SOS Desert organisation grow crops for sale and manage an firefighting unit putting out bushfires; members of a women’s resource network care for those wounded by jihadist attacks and expectant mothers while also promoting awareness about educating girls.

But the camp’s requirements 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 recycle what little we have, but it is not enough for the demands of the camp.”

In the schools, the children are given 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 mostly unseasoned, save for a few pulses.

“We’re still providing school meals, basic food distributions, and cash assistance 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 diversification of our support network.”

The meals are powered by recent gifts including several thousand tonnes of rice provided by the South Korean government – the only goods in a bulk of the warehouses. A few donors are also helping launch entrepreneurship programmes to help refugees grow crops and rear animals so they can make money and improve their standard of living.

Though Malha supervises everything conscientiously, 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 adequate, sometimes it is not. And when it is not, you endure hardship.

“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 self-respect.”