Fifty years ago, President Lyndon Johnson declared a war on poverty. The success or failure of that war has been debated ever since. As part of our anniversary coverage, NPR's Pam Fessler is reporting on the difficulties of living in poverty and on how hard it is to get out. Today, she brings us this story from Steuben County in western New York.

PAM FESSLER, BYLINE: Desiree Metcalf's story is heartbreaking but not unique. There are many Desirees among the 46 million Americans who are poor today. This one is 24 years old, the mother of three little girls - six, four and two. They all have different fathers.

DESIREE METCALF: That about sums me up, I think.

FESSLER: Desiree is sitting on the floor of her two-bedroom apartment in Bath, New York. A fish tank gurgles in the background. A tiny kitten peeks out from under the furniture. Her youngest daughter is curled up under a blue blanket, head resting on her mother's lap.

METCALF: Are you shy? No? OK.

FESSLER: Desiree got married two years ago to a man who isn't the father of any of her children but he recently left her for someone else.

METCALF: Oh, I just feel like I get one piece of good news that makes me, hey, life isn't going to be that bad and then here comes 30 things to basically push me right back down in this hole that I've been trying to dig myself out of for the last probably 15 years.

FESSLER: Fifteen years. Desiree did not just become poor. A lot of bad things happened to get her here. Like others who are poor, she doesn't have just one or two problems, but a whole pile of them.

METCALF: A long story.

FESSLER: Desiree was raised by a single mother, also poor. Desiree says they didn't always get along. And things came to a head when she was 12.

METCALF: My mom and I got in a fight and she told me she was going to kill me. And I wrapped a belt around my neck and told her I would do it for her. I ended up in a psychiatric hospital and from there I went to foster care.

FESSLER: And from home to home to home. She attended 26 different schools.

METCALF: Seems I'd just get my bags unpacked and it was time to move again, so.

FESSLER: Desiree admits she was no saint.

METCALF: I used to be an alcoholic. I used to self-harm.

FESSLER: Which means she cut herself to feel the pain. Today, she has tattoos on her arms to cover the scars.

METCALF: I smoked cigarettes like a chimney.

MARIAN RECELMAN: I first knew Desiree when she was 15 and I was in a different agency working with her family with the goal of reunification.

FESSLER: That's Marian Recelman, now with ProAction, a local non-profit agency, still trying to help.

RECELMAN: She did come back and graduated from high school and was all set to go to college.

FESSLER: In Florida, with a full scholarship.

RECELMAN: And then turned up pregnant.

FESSLER: Yup, another single teenage mom. But again, not that unusual. Half of all girls in foster care get pregnant by the time they're 19. Desiree knew that her life had taken a detour.

METCALF: That was my ticket out of here, so to speak. So, here I am. Not in Florida.

FESSLER: Like many before her, Desiree carried her poverty into adulthood, doing odd jobs with periods of homelessness and hunger. But here's what's even more disturbing: that poverty is now starting to take its toll on her children, especially her oldest daughter, who recently tried to run away from home in the middle of the night.

METCALF: She's got some emotional issues. And, I mean, we went through everything from making ourselves puke after we eat to running away to wanting to kill themselves and she's six years old.

FESSLER: Six years old. So, you might be asking yourself, isn't there some help this family can get? Well, yes, there's plenty. The government and charities have spent thousands, if not tens of thousands of dollars, on Desiree and her family - on food stamps, health care, housing, Head Start - many of the programs that emerged from the war on poverty. But clearly they haven't done the trick, for many reasons. First, Desiree can't get a job, even though the government spent almost $3,000 to train her as a certified nursing assistant.

METCALF: That's something I've always wanted to do.

FESSLER: But her car was recently totaled by someone backing out of a driveway.

METCALF: So, now my vehicle is gone and have no way to get back and forth to work reliably and, unfortunately, there's not much in this town as of work and...

FESSLER: Mass transit is virtually nonexistent in this rural area. And with her husband gone, Desiree - like many low-income workers - has something else to worry about.

METCALF: If you get a job and they take you off public assistance, then they don't pay for daycare.

FESSLER: An expense that would likely eat up most of her earnings. And Desiree faces another Catch-22. She knows if she starts making money, other benefits, like food stamps, will be cut or eliminated. Just recently, her family's food stamp benefit dropped from $700 a month to $200 because her daughter started to get big Social Security checks to treat her emotional issues and her husband began working part-time at McDonalds. Of course, now he's gone.

METCALF: I guess the system, to me, seems backward. I mean, they should be more for helping you, not kind of setting you up to fail, so to speak.

FESSLER: And there's one more thing: you might notice that Desiree is sometimes difficult to understand. That's because most of this 24-year-old's top front teeth are missing. Gum disease. Medicaid paid $3,000 for a partial bridge, but now she can't use it because her other teeth are crumbling.

METCALF: It doesn't bother me. I got summer teeth - some are here, some are gone, some are somewhere.

FESSLER: But it's probably not helping much with her job search. Social worker Marian Recelman says Desiree could get more dental work using Medicaid, but...

RECELMAN: There are very few providers who will accept it and none in this community. So, you have to find one and then travel to it.

FESSLER: Again, Desiree has no transportation. It's seems there's a roadblock at every turn.

RECELMAN: It's distressing because you have to be so motivated and capable to navigate those systems and come out ahead.

FESSLER: It's a complaint that you hear again and again, not just from those who get government aid but also from providers. Kathryn Muller is the commissioner of social services for Steuben County. She says her office provides many services for struggling families.

KATHRYN MULLER: Really, it's sometimes handholding. It's working with employers and putting case managers with individuals who are starting employment and helping them.

FESSLER: But, she says, sometimes their hands are tied by state and federal law. One example: Welfare recipients can meet their work requirements by going to school but only for one year.

MULLER: One year is great. It's better than what used to be, but you can't get an associate's degree in one year.

FESSLER: Even though, she says, one of the main reasons people can't get work here is a lack of education. Muller says some of the limits are there to prevent people from abusing the system but there's also a misperception about the poor.

MULLER: It's not a chosen lifestyle. Certainly there is abuse out there, there's abuse no matter what it is. But it's not a chosen lifestyle.

FESSLER: Desiree could not agree more. She just wishes it wasn't such a struggle to get help. Amazingly, though, with all she's been through, she still hopes she'll someday get to college.

METCALF: Someday. I haven't given up my dream yet. I just keep putting it on the back burner, until it ain't raining so hard, I guess.

FESSLER: Pam Fessler, NPR News.