It took us about 45 minutes to walk to the falls from where our taxi driver dropped us off. You definitely need comfortable hiking attire and shoes for the trek, and ones that you don't mind getting dirty. Middleham Falls is a hidden gem, and it's well worth the hike. I am not a strong swimmer but the rest of my group climbed down to the falls for a swim. Don't make the same mistake I did, go for it and get a closer look. :D As for Ti Tou Gorge, I definitely went in and swam in the super cold river. The cold water temperature takes a lot of swimmers' energy, thus most of the people in my group opted to wear a life jacket. Overall, it is such a magnificent place. I love Dominica! I was at the Trafalgar Falls a few years ago and I was able to go by the waterfalls and lay in the hot springs. Definitely a must.
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