Igigi unrest leading to the Zu Incident was just a harbinger of other troubles to come—troubles inherent in long-term interplanetary missions—female companionship was one of the significant problems.

The problem was less acute with the Earth-stationed Anunnaki, since they contained females from the first landing party (some named and assigned tasks in Enki’s autobiography). In addition, a group of nurses led by their daughter of Anu was sent to Earth. She was known as Ninmah ("Mighty Lady"); her role on Earth was that of Sud ("one who gives succor"): She served as the Anunnaki’s chief medical officer and was crucial to any subsequent events.

Its ancient tide echoed its opening words: Inuma ilu awilum ("When the gods became like men"). However, there was also trouble among the Earth-based Anunnaki, especially those assigned to mining duties. Several unintended consequences resulted from the Anunnaki’s Mutiny in the Atra-Hasis Epic, which tells of an uprising by the Anunnaki who refused to work in the gold mines.

While the gods, like men, bore the toil and work, there was great toil for the gods, and the result was heavy; there was much distress.

The very Akkadian term, Awilu, means "employee", rather than simply "man", as it is usually translated. In the epic tale, the man takes over the work of the gods. Despite the absence of men on Earth, the gods toiled as though they were men. Enki and Ninmah achieved that feat, but it was not a story with a happy ending, as far as Enlil was concerned.