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A number of times a week, Mohamed ‘Momo’ Ag Malha treks at least 7 miles (11km) around the enormous Mbera refugee camp in south-eastern Mauritania that has been his home since 2012. The activity keeps the 84-year-old camp coordinator mentally and physically fit, and enables him to assess the condition of other inhabitants.

His first stay in Mauritania happened in 1991, when he escaped Mali as Tuareg insurgents fought with the army in his native Timbuktu region.

After four years as a refugee, he went back and worked for a year as a social worker before becoming 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 young inhabitants of Mbera, which is positioned approximately 30 miles from the Malian border.

“Some of the young ones who were born here in Mbera have never even seen Mali,” he says. “They do not know their country [and] that is painful 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.”

Initially conceived as a few thousand shelters, Mbera now accommodates around 120,000 refugees, according to UNHCR. In addition, it is estimated 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 largest human community in Mauritania after Nouakchott and Nouadhibou, the administrative and commercial hubs.

Each month, thousands more refugees pour in across the border, fleeing a jihadist insurgency that took over the Tuareg rebellion and has since left large parts of the country ungovernable. Aid workers – particularly at the UN World Food Programme (WFP) and Unicef office in the town of Bassikounou, which assists the camp and nearby settlements – cannot stop being concerned. They have faced shrinking resources as foreign donors – most notably the now defunct 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 stop 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 shops, and volleyball and football programmes. Members of a parent-teacher association use loudspeakers to get more children enrolled in school. New arrivals are processed by aid workers and state agents using digital identification.

Nearby, police patrols guard the camp from the danger of armed groups 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 injured by jihadist attacks and mothers-to-be while also promoting awareness about schooling girls.

But the camp’s requirements are clear.

“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 served 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 focusing on the most needy while working relentlessly to secure new funding through the broadening of our donor base.”

The meals are powered by recent gifts including several thousand tonnes of rice supplied by the South Korean government – the only products in a majority of the warehouses. A few donors are also helping initiate entrepreneurship programmes to help refugees grow crops and keep animals so they can earn an income and boost their livelihood.

Though Malha oversees everything conscientiously, helping the aid workers’ support the most disadvantaged households, his heart aches 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 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.”