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The 70 mile long river starts at Turners Hill, at the West Sussex border, and through Kent to meet the Thames Estuary. It travels through many major towns, including Tonbridge, Maidstone, Strood and Rochester. The river has many locks from Tonbridge to Allington, where the river becomes tidal. Boats can navigate the river up to Tonbridge. At Yalding there is a short diversion along the Hampstead Road Canal, whilst the river goes over sluices and below the Twyford Bridge.
After floods devastated Tonbridge in 1968 a substantial flood barrier was built in 1981 on the Medway at nearby Leigh, to protect the town.
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