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Several days 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 home since 2012. The routine keeps the 84-year-old camp coordinator mentally and physically fit, and allows him to check on the wellbeing of other residents.

His initial stay in Mauritania came in 1991, when he left Mali as Tuareg insurgents fought with the army in his home Timbuktu area.

After four years as a refugee, he returned home and worked for a year as a social worker before becoming a teacher. Then in 2012, the Tuareg unrest once again forced him across the border.

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

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

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

Government authorities say the area is the third-biggest human encampment in Mauritania after Nouakchott and Nouadhibou, the administrative and commercial centers.

Each month, thousands more refugees come across the border, running from a militant uprising that co-opted the Tuareg rebellion and has since left large parts of the country ungovernable. Aid workers – especially 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] help almost 90,000 people with both provisions or financial assistance every month to about 53,000 … and had to halt vital nutrition programmes for hungry children and mothers due to funding cuts,” says Aliou Diongue, country director for WFP.

The camp has many of the features of a established settlement, including its own bank, eight schools, a market with more than 500 outlets, and volleyball and football activities. Members of a parent-teacher association use megaphones to get more children registered in school. New entrants are registered by aid workers and state agents using biometric systems.

Nearby, security patrols secure the camp from the threat of armed groups just a few miles from the border.

Some residents have taken on new roles with enthusiasm: volunteers in the SOS Desert organisation farm produce for sale and run an firefighting unit putting out bushfires; members of a women’s resource network look after those wounded by jihadist attacks and expectant mothers while also spreading awareness about schooling girls.

But the camp’s requirements are evident.

“We have the will, we have the women, but not enough resources or equipment,” a leading member of the network says. “Sometimes we reuse what little we have, but it is not enough for the needs of the camp.”

In the schools, the children are served 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 almost plain, save for a few pulses.

“We’re still supplying school meals, basic food distributions, and cash assistance in the Mbera camp, but it’s not enough,” says Diongue. “We’re prioritizing the most vulnerable while working tirelessly to acquire new funding through the expansion 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 most of the warehouses. A few donors are also helping start business programmes to help refugees cultivate and rear animals so they can make money and boost their livelihood.

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

“When you leave your country, you sacrifice 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 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.”