We trip over them on the sidewalk every day. We curse, hand them a dollar, or don't. We feel pity, guilt and rage at their presence. The city spends $200 million a year trying to get homeless people off the streets and into a better way of life - but over 20 years, the problem has only gotten worse.

The more able of the homeless find their way into shelters, counseling and housing programs. But the most chronically indigent, called the hard core, steadfastly refuse most help and stay outside. These 3,000 to 5,000 homeless at the very bottom are the most visible, and they give the city its dubious distinction of having what many call the worst homeless problem in the country.

San Francisco Chronicle reporter Kevin Fagan and photographer Brant Ward spent four months in the streets, parks and alleys with the homeless and those who deal with them-health care workers, police, tourists, residents, businesspeople, commuters-in an attempt to answer the question: How did San Francisco, one of the most sophisticated and cultured cities in the world come to have so many people living so blatantly, so visibly, in misery?

Below is the original "Shame of the City" series published in December 2003.

Island: Life is a hand-to-mouth ordeal for those on Homeless Island
The hard core
Island Photo Series

Families: The Silver family is a rarity among San Francisco's 930 homeless families -- despite living in their van, their children do well at school.
Families Photo Series
The Silvers: Chat Transcript

Shelter: Word on the street is that homeless shelters are dangerous drug dens, but that's not what The Chronicle found.
Shelter Photo Series

Enablers: The aid San Francisco provides the homeless perpetuates the problem.
Territories of the Homeless
Homeless Geography of S.F.
Mapping SF's Homeless Haunts
'Mascots' Live Better
Enablers Photo Series

Solutions: San Francisco knows how to solve its problem with homelessness, but it needs decisionmakers to agree on a plan.
Candidate's Positions
Solutions Photo Series