Water-related diseases are still a leading cause of death in developing countries. Though the relationship between water-related disease mortality rates and water sanitation and hygiene measures is well documented, the means to provide proper water and sanitation treatment remain elusive. This paper examines the effect of hard infrastructure on water-related disease rates and proposes that building infrastructure is the best way to reduce the prevalence of water-related disease in rural African villages. It examines the history of sanitation infrastructure in developed countries as well as why similar measures are difficult to implement in sub-Saharan Africa. This paper analyzes three rural African countries’ sanitation infrastructure systems (Botswana, Rwanda, Swaziland) to recommend best practices in rural African villages. Recommendations for future infrastructure systems are given as well as how governments can best implement those systems to reduce water-related disease mortality rates.